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Br J Gen Pract. 2006 October 1; 56(531): 810.
PMCID: PMC1920740

Losing our way

Getting lost can be exhilarating.

Recently three of us bundled our bikes onto a cross-channel ferry for an impromptu cycle tour of rural Brittany. We travelled light, so light that we didn't pack a map. Our only guide was a scrap of paper — a brief article in the travel section of the Times that inspired the trip in the first place. Unsurprisingly we got lost a lot. Sometimes our unplanned detours were frustrating, wandering around soulless industrial areas guarded by slavering dogs behind worryingly flimsy fences. Thankfully, more often they took us to delightful corners, off the beaten track, where we came across sights and characters that we would never have happened upon on a more organised trip. This infused the trip with a relaxed joy and we had that deep sense of delight that comes from stumbling across a simple pleasure.

On our last day we sat outside for breakfast in the charming medieval town of Dinan. The early morning sun sparkled on the river Rance as it made its serene way to St Malo, where our return ferry also waited. We gazed cheerfully on a vertical looking climb out of the town. We weren't bothered that soon we would be puffing painfully up its slopes and struggling to get back in time for that ferry. Our table rattled on the cobbled pavement as we hungrily buttered our croissants and laughed at anything and everything. Next day we would be back in work but it might as well have been next year. We were briefly back in the childlike state of relishing the present and carefree about the future. If I could bottle that feeling of peace and contentment SSRIs and CBT would be footnotes in the history of psychiatry.

Others aren't so lucky. Earlier this year the villagers in Luckington noticed a regular procession of cars plunging into a deep ford that ran through their village. This lemming like behaviour was caused by a road closure, which the drivers' satellite navigation equipment hadn't taken into account. They had such unquestioning faith in the technology that they ignored their own senses and slavishly followed the GPS instructions all the way into the water. When did they realise that something was wrong? When the water splashed on the windscreen? When it started lapping around their ankles? I imagine some of them still kept their faith in the technology even as the tractors pulled them out of the water. Sometimes the most sophisticated gadgets are no better than a scrap of paper.

I worry when, in the name of promoting health, we make healthy people into patients. When prevention means more and more pills and procedures for people who feel well, I think about wrong turnings — even though evidence-based medicine is confidently steering us in that direction. And when I see the spectre of all men over a certain age being on a statin I start to see the splashes of water on my windscreen and feel my socks getting wet.

Like GPS technology, clinical trials, meta-analyses and statistics are fallible. Why is there such a chasm between how we assess quality in our professional and non-professional life? In work we only trust measurements on a mythical uniform, average population. Outside work we value individuality, spontaneity, curiosity, and trust our instincts. If we don't value these in our professional life as well we will become slaves to technology like those hapless drivers.

The delight of those few days in France has spurred me on to exercise regularly again and the British Heart Foundation website tells me that cycling will cut down my risk of heart disease by 50%. I don't know how that compares with statins but my instincts tell me to stick to pushing pedals rather than pills for my primary prevention.


Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners